Peritonsillar abscess
- Collection of pus between capsule of palatine tonsil and the pharyngeal muscles typically preceded by tonsillitis or pharyngitis
Differential diagnosis:
- Epiglottitis, retropharyngeal abscess
- Parapharyngeal space abscess
Management:
- Prompt surgical intervention if airway compromise - needle aspiration/incision and drainage
Usual Pathogens
Frequently polymicrobial:
Group A Strep
S. anginosus group
S. aureus/MRSA
oral anaerobes
Rarely:
Haemophilus spp
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Amoxicillin-clavulanate | 1.2g IV q8h | 10 days |
| If MRSA risk factors, add: | ||
| Vancomycin | 15mg/kg IV q12h | 10 days |
Amoxicillin allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Cefuroxime | 1.5g IV q8h | 10 days |
| + | ||
| Metronidazole | 500mg IV q12h | |
| If MRSA risk factors, add: | ||
| Vancomycin | 15mg/kg IV q12h | 10 days |